Search

Objective: To generate longitudinal fetal growth data in an Indian population and compare it with Intergrowth-21st. Material and methods: Fetal biometry data was collected in a prospective longitudinal observational study (REVAMP: Research Exploring Various Aspects and Mechanisms in Preeclampsia) from 2017 to 2022. Fetal crown-rump length (CRL) was measured at 11–14 weeks gestation, and biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) at 18–22 and 32–35 weeks, and converted into Z-scores using the Intergrowth standard. Generalized Additive Models for Location, Scale and Shape (GAMLSS) models were used to construct fetal growth centile curves compared against Intergrowth centiles. Results: Out of 1096 singleton pregnancies in REVAMP, this analysis included 655 'healthy' pregnancies (uncomplicated by pre-eclampsia, diabetes, pre-term delivery or low birth weight) and a sub-set of 106 'low-risk' pregnancies defined using Intergrowth criteria. The 'healthy' study subjects showed lower mean CRL Z-score [-0.45 SD (95% CI:-0.54,-0.37)] at 11–14 weeks, and BPD Z-score [-1.2 SD (-1.28,-1.11) and -1.17 SD (-1.23,-1.1)] at 18–22 and 32–35 weeks respectively. Mean HC Z-score was comparable to the Intergrowth standard at 18–22 weeks [-0.08 SD (-0.16, 0.02)] but smaller at 32–35 weeks [-0.25 SD (-0.32,-0.19)]. Mean AC Z-score was lower at 18–22 weeks [-0.32 SD (-0.41,-0.23)] but comparable at 32–35 weeks [0.004 SD (-0.07, 0.07)]. FL was comparable to or larger than the Intergrowth standard at both time points [0.05 SD (-0.05, 0.14); 0.82 SD (0.75, 0.89), respectively]. These findings were similar, though measurements were slightly larger, in the 'low-risk' sample. Conclusions: This data from healthy and low-risk pregnant women in urban western India indicates that some fetal dimensions and growth trajectories differ significantly from the Intergrowth-21st. Our data suggest the need for a larger representative study to define a population-specific fetal growth reference for India, for identification of fetal growth restriction. [ABSTRACT FROM AUTHOR]

Problem: C‐reactive protein (CRP) is a marker for inflammation and its role as a possible biomarker for an early prediction of pre‐eclampsia (PE) is unclear. The present study investigates the levels of high‐sensitivity CRP (hs‐CRP) longitudinally across pregnancy in women with PE and compares them to women without PE (non‐PE). Method of Study: A total of 324 pregnant women [216 non‐PE and 108 PE women] were included in this study. Maternal blood was taken at four different intervals (V1 = 11–14 weeks, V2 = 18–22 weeks, V3 = 26–28 weeks, and V4 = at delivery). Results: Maternal serum hs‐CRP levels were higher at V1, V2, and V3 (p <.05 for all) in the PE group compared to the non‐PE group. The hs‐CRP levels were associated with maternal blood pressure throughout pregnancy. Maternal hs‐CRP levels did not differ among early and late onset PE. Higher maternal hs‐CRP levels were associated with the increased risk of PE in unadjusted model in early pregnancy. However, there was no significance after adjusting for confounding factors. Conclusions: Our findings suggest although the levels of hs‐CRP were higher in PE in early pregnancy, they are not associated with an increased risk of PE. [ABSTRACT FROM AUTHOR]

Studies from high-income countries report associations of preeclampsia (PE) with reduced cognitive function and adverse behavioural outcomes in children. We examined these associations in Indian children aged 5-7 years. Children of mothers with PE (n=74) and without PE (non-PE; n=234) were recruited at delivery at Bharati Hospital, Pune, India. The cognitive performance was assessed using 3 core tests from the Kaufman Assessment Battery and additional tests including Verbal fluency, Kohs block design, and Coding A (from Wechsler Intelligence Scale for Children). The parent-reported Strengths and Difficulties Questionnaire (SDQ) was used to assess children's behavioral characteristics. Scores were compared between children from PE and non-PE groups, and associations analyzed further using regression models, adjusted for potential confounders. After adjusting for age, sex, socio-economic status and maternal education, children of PE mothers had lower Kohs block design scores (adjusted odds ratio per score category 0.57, [95% CI 0.34-0.96] p=0.034; 0.62 [95%CI (0.36, 1.07), p=0.09 on further adjustment for birth weight and gestation) compared to children of mothers without PE. In the SDQ, there was a lower prevalence of abnormal 'conduct problem' scores in PE group than non-PE group (OR=0.33, 95% CI 0.13-0.83, p=0.018, in the fully adjusted model); there were no differences for other behavioral domains. This preliminary study in Indian children suggests that fetal exposure to maternal PE may have an adverse impact on visuo-spatial performance but does not adversely affect behavior. Further studies with larger sample sizes are essential to understand effects of maternal PE on cognitive/behavioral outcomes in children. [ABSTRACT FROM AUTHOR]

Objective: To generate longitudinal fetal growth data in an Indian population and compare it with Intergrowth-21st. Material and methods: Fetal biometry data was collected in a prospective longitudinal observational study (REVAMP: Research Exploring Various Aspects and Mechanisms in Preeclampsia) from 2017 to 2022. Fetal crown-rump length (CRL) was measured at 11–14 weeks gestation, and biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) at 18–22 and 32–35 weeks, and converted into Z-scores using the Intergrowth standard. Generalized Additive Models for Location, Scale and Shape (GAMLSS) models were used to construct fetal growth centile curves compared against Intergrowth centiles. Results: Out of 1096 singleton pregnancies in REVAMP, this analysis included 655 'healthy' pregnancies (uncomplicated by pre-eclampsia, diabetes, pre-term delivery or low birth weight) and a sub-set of 106 'low-risk' pregnancies defined using Intergrowth criteria. The 'healthy' study subjects showed lower mean CRL Z-score [-0.45 SD (95% CI:-0.54,-0.37)] at 11–14 weeks, and BPD Z-score [-1.2 SD (-1.28,-1.11) and -1.17 SD (-1.23,-1.1)] at 18–22 and 32–35 weeks respectively. Mean HC Z-score was comparable to the Intergrowth standard at 18–22 weeks [-0.08 SD (-0.16, 0.02)] but smaller at 32–35 weeks [-0.25 SD (-0.32,-0.19)]. Mean AC Z-score was lower at 18–22 weeks [-0.32 SD (-0.41,-0.23)] but comparable at 32–35 weeks [0.004 SD (-0.07, 0.07)]. FL was comparable to or larger than the Intergrowth standard at both time points [0.05 SD (-0.05, 0.14); 0.82 SD (0.75, 0.89), respectively]. These findings were similar, though measurements were slightly larger, in the 'low-risk' sample. Conclusions: This data from healthy and low-risk pregnant women in urban western India indicates that some fetal dimensions and growth trajectories differ significantly from the Intergrowth-21st. Our data suggest the need for a larger representative study to define a population-specific fetal growth reference for India, for identification of fetal growth restriction. [ABSTRACT FROM AUTHOR]

Highlights: [•] Higher milk DHA levels in mothers with preeclampsia up to 3.5 months of lactation. [•] Lower milk NGF levels in preeclampsia at 1.5 and 3.5 months of lactation. [•] Reduced milk BDNF levels in the preeclampsia at 1.5 months of lactation. [ABSTRACT FROM AUTHOR]

Abstract: A disturbed fatty acid metabolism increases the risk of adult non-communicable diseases. This study examines the effect of maternal micronutrients on the fatty acid composition, desaturase activity, mRNA levels of fatty acid desaturases and transport proteins in the liver. Pregnant female rats were divided into 6 groups at 2 levels of folic acid both in the presence and absence of vitamin B12. The vitamin B12 deficient groups were supplemented with omega 3 fatty acid. An imbalance of maternal micronutrients reduces liver docosahexaenoic acid, increases Δ5 desaturase activity but decreases mRNA levels, decreases Δ6 desaturase activity but not mRNA levels as compared to control. mRNA level of Δ5 desaturase reverts back to the levels of the control group as a result of omega 3 fatty acid supplementation. Our data for the first time indicates that maternal micronutrients differentially alter the activity and expression of fatty acid desaturases in the liver. [Copyright &y& Elsevier]

The purpose of this study was to examine the maternal and cord long-chain polyunsaturated fatty acid (LCPUFA) concentrations and their associations with birth outcome in term deliveries. Pregnant women ( n = 253) delivering at term were divided into two groups based on their babies' birth weights (1) normal birth weight (NBW), that is, ≥2.5 kg ( n = 190) and (2) low-birth weight (LBW), that is, <2.5 kg ( n = 63). Each group is further divided into two groups according to the baby's sex, that is, male NBW (M-NBW), female NBW (F-NBW), male LBW (M-LBW), and female LBW (F-LBW) groups. Maternal plasma docosahexaenoic acid and erythrocyte arachidonic acid (AA) levels were lower ( P < 0.05 for both), while cord plasma docosahexaenoic acid and erythrocyte AA levels were higher ( P < 0.05 for both) in LBW group when compared to the NBW group. Maternal erythrocyte AA levels were positively associated with birth weight ( P = 0.001), while cord plasma docosahexaenoic acid levels were negatively ( P = 0.05) associated with birth weight. Reduced maternal and increased cord LCPUFA levels exist in mothers delivering LBW babies, especially in mothers delivering female babies, indicative of sex-specific effects. Am. J. Hum. Biol., 2011. © 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Potential adverse effects of excess maternal folic acid supplementation on a vegetarian population deficient in vitamin B12 are poorly understood. We have previously shown in a rat model that maternal folic acid supplementation at marginal protein levels reduces brain omega-3 fatty acid levels in the adult offspring. We have also reported that reduced docosahexaenoic acid (DHA) levels may result in diversion of methyl groups towards DNA in the one carbon metabolic pathway ultimately resulting in DNA methylation. This study was designed to examine the effect of normal and excess folic acid in the absence and presence of vitamin B12 deficiency on global methylation patterns in the placenta. Further, the effect of maternal omega 3 fatty acid supplementation on the above vitamin B12 deficient diets was also examined. Our results suggest maternal folic acid supplementation in the absence of vitamin B12 lowers plasma and placental DHA levels (p,0.05) and reduces global DNA methylation levels (p,0.05). When this group was supplemented with omega 3 fatty acids there was an increase in placental DHA levels and subsequently DNA methylation levels revert back to the levels of the control group. Our results suggest for the first time that DHA plays an important role in one carbon metabolism thereby influencing global DNA methylation in the placenta. [ABSTRACT FROM AUTHOR]

Abstract: Altered maternal micronutrients (folic acid, vitamin B12) are suggested to be at the heart of intra-uterine programming of adult diseases. We have recently described interactions of folic acid, vitamin B12 and docosahexaenoic acid in one carbon metabolism that is considered to play a key role in regulation oxidative stress and chromatin methylation. However its impact on fetal oxidative stress and brain fatty acid levels has been relatively unexplored. The present study examined the effect of imbalance in maternal micronutrients (folic acid and vitamin B12) and maternal omega 3 fatty acid supplementation on oxidative stress parameters and brain fatty acids and in the offspring at birth. Pregnant female rats were divided into six groups at two levels of folic acid both in the presence and absence of vitamin B12. Both the vitamin B12 deficient groups were supplemented with omega 3 fatty acid. Oxidative stress marker (malondialdehyde) and polyunsaturated fatty acid profiles in plasma and brain were analyzed in dam and offspring at d20. Our results for the first time indicate that imbalance in maternal micronutrients (excess maternal folic acid supplementation on a B12 deficient diet) increases (p <0.01) oxidative stress in both mother and pups. This increased maternal oxidative stress resulted in lower (p <0.01) fetal brain DHA levels. Omega 3 fatty acid supplementation was able to restore (p <0.05) the levels of brain DHA in both the vitamin B12 deficient groups. Our data has implications for implications for neurodevelopmental disorders since micronutrients and DHA are important modulators for neural functioning. [Copyright &y& Elsevier]

Objective: To generate longitudinal fetal growth data in an Indian population and compare it with Intergrowth-21st., Material and Methods: Fetal biometry data was collected in a prospective longitudinal observational study (REVAMP: Research Exploring Various Aspects and Mechanisms in Preeclampsia) from 2017 to 2022. Fetal crown-rump length (CRL) was measured at 11-14 weeks gestation, and biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) at 18-22 and 32-35 weeks, and converted into Z-scores using the Intergrowth standard. Generalized Additive Models for Location, Scale and Shape (GAMLSS) models were used to construct fetal growth centile curves compared against Intergrowth centiles., Results: Out of 1096 singleton pregnancies in REVAMP, this analysis included 655 'healthy' pregnancies (uncomplicated by pre-eclampsia, diabetes, pre-term delivery or low birth weight) and a sub-set of 106 'low-risk' pregnancies defined using Intergrowth criteria. The 'healthy' study subjects showed lower mean CRL Z-score [-0.45 SD (95% CI:-0.54,-0.37)] at 11-14 weeks, and BPD Z-score [-1.2 SD (-1.28,-1.11) and -1.17 SD (-1.23,-1.1)] at 18-22 and 32-35 weeks respectively. Mean HC Z-score was comparable to the Intergrowth standard at 18-22 weeks [-0.08 SD (-0.16, 0.02)] but smaller at 32-35 weeks [-0.25 SD (-0.32,-0.19)]. Mean AC Z-score was lower at 18-22 weeks [-0.32 SD (-0.41,-0.23)] but comparable at 32-35 weeks [0.004 SD (-0.07, 0.07)]. FL was comparable to or larger than the Intergrowth standard at both time points [0.05 SD (-0.05, 0.14); 0.82 SD (0.75, 0.89), respectively]. These findings were similar, though measurements were slightly larger, in the 'low-risk' sample., Conclusions: This data from healthy and low-risk pregnant women in urban western India indicates that some fetal dimensions and growth trajectories differ significantly from the Intergrowth-21st. Our data suggest the need for a larger representative study to define a population-specific fetal growth reference for India, for identification of fetal growth restriction., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kinare et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Maternal fatty acid nutrition during pregnancy and lactation determines the transfer of long-chain polyunsaturated fatty acids via the placenta and through human milk. Neural maturation of breast-fed infants is known to be linked to breast-milk long-chain polyunsaturated fatty acid concentrations. In spite of this, the fatty acid composition of breast milk in pre-eclamptic mothers is poorly understood., Objectives: To compare the fatty acid composition of breast milk of pre-eclamptic (n = 45) with normotensive (n = 85) mothers and examine the association of breast-milk fatty acids with plasma fatty acids., Methods: Milk and plasma fatty acid methyl esters were prepared and analyzed by the modified method of Manku and colleagues using gas chromatography., Results: Docosahexaenoic acid (DHA) concentrations were significantly increased (p < 0.01) in breast milk in spite of lower maternal plasma DHA concentrations (p < 0.05) in pre-eclamptic women. However, there was no difference in arachidonic acid levels between groups in spite of reduced maternal plasma arachidonic acid levels., Conclusions: The data suggest that in pre-eclampsia, the relation between plasma and milk DHA is altered. The resulting higher milk DHA concentrations are beneficial for infants., (Copyright 2009 S. Karger AG, Basel.)